Questions as I close in on goal/maintenance time.

 I apologize for posting on the maintenance board; but I have a couple of questions for the vets – and preferably just the vets.  I don’t want to offend anyone on the main VSG board, so thought I would just come here.

At my last appointment with my surgeon, he told me to increase my calories slowly from 500 to 700 in the next month.  I am approaching goal, and since I had been doing so well I balked a little bit at the idea of increasing calories.  Seriously, I was frightened.  But even with being sick earlier in the week, I did as my doctor said.  I am around 600 calories now and have found something strange happening.  First, my mini-stall I was in broke.  (I call them mini stall – they last about 5-9 days and I bounce up and down on the scale around the same 2 lbs or so).  The stall broke, and at first I thought it was due to the stomach bug I had.  But since then – I keep going down, even with the increased calories.  And not just going down slowly – but at an increased pace than I experienced the past month.  For instance, the first day the stall broke I went down .6 lbs.  The next day – 1.2 lbs.  This morning – 1.8 lbs.  I don’t even know what to think really.  Is this a normal thing to happen after an increase in calories – or is this still attributable to my illness (that I seem to have completely recovered from).  Any information, thoughts or insight is appreciated.

For my second concern – I am getting closer to my goal.  I am now only like 23 lbs away.  At the rate of my loss (normal – not the recent increase) I should hopefully reach goal by October or November.  Here’s my concern about reaching goal.  I now know how to lose – I can follow that plan pretty well.  By all accounts, I definitely know how to GAIN.  What I have not accomplished is maintaining - ever.  I am finding that I am anxious and nervous about hitting goal and then the idea of trying to maintain that goal.  My surgeon said that after I hit goal, it should be close to my next follow up visit, and he wants to see where I am body and health wise, as he still thinks my small body is more suited to a lower goal than the 115 I have set.  I could probably keep on the losing path – but my true goal is to be HEALTHY.  I know that healthy means maintaining, and then the anxious thoughts come rushing back in.  How to maintain without ending back on a vicious cycle of gaining and losing and gaining and losing?  Does anyone else have experience with this or these kinds of thoughts?  I seriously am open to most input. 

Thank you for taking the time to read – and for any responses. J

Hey no apologies needed! This board is here for questions like this, for folks thinking ahead.. I regularly lurked in here, and really appreciated the insight and experience of folks a lot further out than me (still do!)

There's a few schools of thought regarding increasing cals. I naturally shifted up from 600ish to 700-750 towards the end. I was out of the 500's regularly by mo 3 I believe. I didn't go much higher than 750 during my active loss time, save for the occasional blip day. So considering you are getting close to a normal weight and have less fat reserves- this seems (to me) like good advice. I'm still trying to stay at 800-1000 now, to slowly shift a few more lbs. Sounds like you have a good doc all the way around.

The mini-stall breaking may have been chance, who knows? That was a weight loss pattern I fell into with the last 30 or so that I lost. I went from being a weekly loser, to holding and going up on the scale for 10-15 days, followed by a 10 day drop leading up to my period, where I'd start the gain again.. Hormones are fun! 

Ah, the anxiety about life after VSG, after the losing stops and the focus has to shift.. that's hard.

I'm a fantastic loser too! I can do it with the best of them, and maintaining.. well, I managed to hold onto a 100lb loss for a few years.. maybe 5 or so, but I eventually slowly regained it, and managed to not put the breaks on till too late. So, it's a painful/anxiety provoking head trip to be getting close to again.

For me, it's going to be doing exactly what I'm doing now (which I never did before).. being totally accountable to me.. daily logging, weighing, working on the head stuff that tells (told me) that I *shouldn't* weigh today because I did XYZ yesterday.. Like somehow not knowing was better? I also am treating my body better nutritionally than I ever have before.. before it was all about how low cal can I go, now it's how much nutritionally dense, good for me, great tasting food can I eat and be on plan.. Keeping myself within a range of lbs as I figure out what that should be, and learning what maintaining that entails with both eating and exercise is a science experiment at the moment.. as it will be for you when you get close.

It will be a slow process of adding back healthy stuff till you find balance, a little at a time, a few hundred Cal's a week max.. then holding on and waiting to see what happens.. Years ago for me- it was "Yay! Goal! Where's my cheeseburger?!" Times have changed.. 

Keep reading in here, and post away!

I can't speak to the second question because so far I suck at maintenance. I'm 30 lbs below goal weight. But I can address your first experience with some expertise.

I was at 600-800 calories from as soon as I got that high after surgery (around 2 months I think) to goal of 175 lbs. Then I bumped up to 1000. First I stalled a couple of weeks, then started losing quite quickly again. So up to 1200. Stall, then rapid loss. Up to 1400, stall, then somewhat slower loss. Up to 1600...stall, even slower loss. I'm at 2000 now (caution - I am VERY active) and after 5 weeks of no appreciable loss have started losing again. Sigh.

I believe my metabolism, driven by me being so much more active than I was pre-op, is adjusting to each raise in calories by gonig up. I am no longer cold all the time, a sign my metabolism has improved tremendously. This may be what happened to you - your metabolism sped up with the increase in calories.

That's not a message to keep increasing by the way - our bodies often will respond to any change by breaking a stall, but keep your calories in the range your surgeon recommends to goal would be my advice.

I can't really address your first issue as I too stayed at 600-800 calories a day until I hit 150, which was my goal. Then I had my gallbladder removed, and lost another 6 lbs--I found out later that metabolism increases when the body heals. Then I had a facelift and lost another 6. Then things leveled off and I have been within the same 2 lb range since February. I am strong and have a lot of energy so I think this is where I'm supposed to be, weightwise. I truly think that your maintenance weight should be one where you feel mentally and physically comfortable and where you can maintain without feeling permanently deprived. I have an upper limit of 140 for myself. If I get higher, it's back to shakes and protein only. So far, it hasn't happened, but I know that's what I'll do if I need to.

Maintenance is like a see-saw for me, but it's kind of fun.

 Thank you all for your input and information.  I am hoping to be successful at this entire process.  I enjoy losing - but I don't want to have my fear turn into some kind of eating disorder (I have had a couple friends say that I will only reach goal by having one). I will keep reading these boards, I find them to be highly insightful. 

there are lots of posts in this group about making the transition to maintenance after reaching goal so its worth looking through the old posts for ideas.

Yes, i was a little fearful about getting to goal and then maintaining. I actually ended up blowing past goal and losing another 15 pounds or so. it was hard to eat more without eating junk which i would not do and don't recomment. you may have to add snacks of healthy stuff. I finally had to eat a spoon or two of peanut butter to get the extra calories. its important to food journal at this time so you know what you really need. I have learned that I maintain on about 1200 calories. thats it. but if i stay away from sugar and carbs its doable. 

if you focus on healthy eating and don't eat chips, sweets, carbs (except on rare occasions) you will do fine. it may take a few months to find your calorie level.  but you lost the weight and you can do this too!

diane

 Thanks!!  I am a chronicler of my food - love the myfitnesspal app.  Was one of the first things I learned from the great vets on this site :) Even considering getting the fitbit in the future. 

1200 calories seems like I will be eating always lol - but I know that eventually I will have to get up there when maintainence arrives. 

 I just recently entered maintenance as well, and had a lot of the same feelings that you are experiencing.  In fact, my support group leader said she thought the transition to maintenance was harder and more confusing to people than the weight loss phase.  Weight loss is defined by very strict guidelines, while maintenance tends to offer more challenges because you have a wider variety of foods, and more of it - at least calorically.

Like you I found that as I started increasing callories, I continued to lose.  All through the first part of July I lost only 1-2 lbs at 600 calories a day.  I started increasing my calories by 200 per week, and suddenly I was down below my goal weight.  I am now up to 1200 a day.  I think I may be at a stable point, but was just cleared for exercise again so I will have to see.   I may stay at 1200 for another week just because I don't like to change too many variables at one time.

Right now my approach to maintenance is to continue applying the practices I learned in weight loss.  Portion control, logging, and accountability.  The difference is that I have more calories to play with.  Right now while I am undergoing a lot of other surgeries (having my bilateral cataracts removed) I have been focusing on driving my protein way high, so I still focus on getting as much protein as I can to promote healing.  I find myself constantly eating, because I am trying to continue undereating my sleeve.  So instead of three meals a day with few or no snacks, I eat three meals a day with three snacks.  I usually try to have a quest bar as a desert so I use that to kill my sweet tooth, and get in an extra protein boost.

Also, since I have been deprived of some of my newly developed exercise stress relievers, I have been working to plan out my meals and snacks.  Even if I don't plan it all outthe night before, nothing goes in my mouth until its in my food journal.  This way I stay mindful of what I eat and how its going to affect my numbers.

Lastly, I am focusing more than ever on my mental aftercare.  I started private counseling to continue to work on my compulsive eating.  I am continuing to work on here and in my support groups.  Keeping my head in the game is paramount.

So far I am feeling like I am doing good at the transition.  I have had a few freak outs and insecurities.  The guys and gals here in the maintenance forum shared their experiences and it really helps.  I realized I am afraid of my weight and theres no need to be.  I am alot more relaxed about it now.  I learned to not focus just on a "goal" number, but a goal range.  As long as I don't cross a certain threshhold in either direction (too low or too high) I am not going to worry about it.  My goal is 190 +/- 5 lbs - so I can go between 185 and 195 and be good.  I am staying on the lookout for trends - Am I being consistent from day to day, am I gaining, or am I losing?  Then I will adjust based on those trends.

Hope this helps!

 It does help!  I have followed your journey and much of your advice since joining the boards.  Thank you for taking the time to reply.  I admit - not the greatest at daily planning.  I am one of the people who cooks on the weekend and freezes baggies/bowls/etc for the week.  I also try to have a lot of protein rich godies on hand.  From you and all the other vets on the board, I have tried to be a sponge.  lol

It feels so much better that I am not the only one to have had these thoughts.  So much better!

 You received some excellent advice and those behaviors and tools are ones that I continue to practice at almost 2 years out. I started logging my food pre-op and learned that it helped me to lose the required weight needed for surgery. I continue to practice it today. It keeps me accountable and on track. Not everyone needs to do this, but for me, it works. I also weigh and measure my food. I prepare my food for the week on Sunday, so I always know what I will be eating and there is always healthy food available. I carry a small cooler in my car, if I am going to be out and about, so that I always have healthy protein and/or veggies available. I ALWAYS have water with me.

Prior to reaching my goal weight, I experienced similar feelings, to those that you are going through now. During the weight loss phase, there is always the goal, but when you reach maintenance, there is a need to develop and work on more goals. For me, I have goals regarding fitness and exercise. For you, it might be something different.

When I hit goal, it was anticlimatic and scary. I had never done maintenance before, so this was new territory for me. I just kept practicing the behavior and using the tools that I had learned during the weight loss phase, but added more calories. So far, it seems to be working, although, I do need to dial some things down, when I see my weight going up. I weigh daily and take an average of my weekly weight on Sunday. This way, I can see trends developing. I have never had to worry about getting too low. LOL!!!

We have similar stats. I am also 4'11' and weigh between 108-110 lbs. My goal was 120, but when I was there, my PCP recommended 110 lbs, so I just kept on doing what I was doing and the weight came off. I am medium-large frame, so I think your frame size will help you to decide on a final weight range. 100-105 lbs might work for you, if you are small frame. I'm not small bone at all and have some muscle, so 100 lbs isn't reasonable for me (at least that is what I think). Sometimes, I think about 105 lbs, but I do have some muscle mass that I don't want to lose, I feel good at an average of 109 lbs. I also have a couple pounds of loose skin, so that may also be a factor. I wear 0-2P, depending upon the brand and style. I can wear some size 14 Girls, again depending upon the cut and brand. I have broad shoulders, so I usually wear a 2-4 on top.

Just keep doing what you are doing and your weight may naturally drop down to 100-105, but if it doesn't, 110 seems good. It is in the middle of the BMI range and is a healthy weight. Your body will find your new setpoint. I am amazed that I weigh 110 today. I think I weighed 120 lbs in 5th or 6th grade, so this is new territory. It will be new territory for you, but with time, you will learn to embrace it, and feel wonderful about what you have done.

Good luck on your journey.

Gail